银杏叶提取物金纳多对低温体外循环红细胞脂质过氧化反应的影响  

Erythrocyte Protective Effects of Ginaton in Patients Undergoing Hypothermic Cardiopulmonary Bypass

作　　者：邓云坤[1] 韦方[1] 张大国[1] 安邦权[1] 刘秀伦[1] 许进福[1] 

机构地区：[1]贵州省人民医院麻醉科,贵阳550002

出　　处：《中国中西医结合杂志》2010年第4期365-368,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：贵州省优秀科技教育人才省长专项资金项目(No.黔省专合字[2005]34);贵州省中医药管理局资助项目(No.[2004]-1)

摘　　要：目的探讨银杏叶提取物金纳多对低温体外循环(CPB)红细胞的保护效果。方法择期行风湿性心脏病二尖瓣置换术患者60例,ASAⅡ～Ⅲ级,全身静脉麻醉后,按随机数字表法分为两组,每组各30例。银杏组:开胸之前给予银杏叶提取物(金纳多)1 mg/kg,静脉滴注,CPB开始前滴完;对照组:以等量生理盐水同速度静脉滴注。分别在CPB开始前(T1)、鼻咽温(降至30～31℃)稳定期(T2)、鼻咽温复温至36℃(T3)、CPB结束后30 min(T4)、CPB结束后3 h(T5)5个时间点采集桡动脉血,测定血浆丙二醛(P-MDA)、红细胞丙二醛(E-MDA)、红细胞超氧化物歧化酶(E-SOD)、钠钾ATP酶、钙镁ATP酶活性。结果与T1比较,对照组T2-5时P-MDA、E-MDA水平升高,T2时E-SOD升高,T3-5时E-SOD浓度降低(P<0.01),银杏组T2-5时P-MDA、E-MDA及E-SOD水平均升高(P<0.05或P<0.01);与对照组比较,银杏组T2-5时P-MDA、E-MDA水平较低,T3-5时E-SOD活性较高(P<0.05或P<0.01)。与T1比较,两组T2时钠钾ATP酶、钙镁ATP酶活性升高,对照组T3-5时这两种酶活性降低(P<0.05或P<0.01);银杏组T2-5时这两种酶活性高于对照组同期(P<0.05或P<0.01)。结论低温CPB期间银杏叶提取物金纳多通过减轻红细胞膜脂质过氧化反应,发挥红细胞保护作用。Objective To investigate the erythrocyte protective effects of Ginaton,a ginkgo biloba extract,in patients undergoing hypothermic cardiopulmonary bypass（CPB）.Methods Sixty patients,who suffered from rheumatic heart disease of ASA grade Ⅱ～Ⅲ and scheduled for mitral valve replacement with intravenous anesthesia,were randomly assigned to two groups equally,the Ginaton group and the control group.They were administered with Ginaton 1 mg/kg and saline respectively via intravenous dripping before open heart surgery before beginning CPB.Blood samples were taken from radial artery at different time points,i.e.before CPB（T1）,nasopharyngeal temperature（30～31℃） stabilized stage（T2）,nasopharyngeal temperature restoration（36℃） stage（T3）,30 min after CPB（T4） and 3 h after CPB（T5）,for determination of malondialdehyde（MDA） and superoxide dismutase（SOD） levels in plasma and erythrocyte（P-MDA,E-MDA,P-SOD and E-SOD）,as well as the Na＋-K＋-ATPase and Ca＋-Mg2＋-ATPase activities in erythrocytes.Results As compared with those at T1,in the control group,P-MDA,E-MDA,and E-SOD at T2-T5 and E-SOD at T2 were higher,but E-SOD at T3-T5 were lower（P〈0.01）;while in the Ginaton group P-MDA,E-MDA,and E-SOD at T3-T4 were higher（P〈0.05 or P〈0.01）.As compared with those in the control group,the levels of P-MDA and E-MDA at T2-T5 were significantly lower,and E-SOD at T3-T5 were higher（P〈0.05 or P〈0.01）.Activities of Na^＋-K^＋-ATPase and Ca^＋-Mg^2＋-ATPase significantly increased at T2 and gradually decreased after then in both groups（P〈0.05 or P〈0.01）,but those at T2-T5 were significantly higher in Ginaton group than in control group（P〈0.05 or P〈0.01）.Conclusion Ginaton displays an erythrocyte protecting effect by way of alleviating the lipid peroxidation in erythrocytes′ membrane.

关 键 词：银杏叶提取物 心肺转流术 红细胞 脂质过氧化 

分 类 号：R285.5[医药卫生—中药学]